龙凤上海shlf1419

Original pediatric doctor Yan, pediatric doctor Yan

Since the second half of 2023, Meituan and JD.COM Platform have carried out rapid home nucleic acid detection in some cities. At present, the testing items are as follows:

There are always parents who ask me: Is the quick test of nucleic acid at home accurate or not?

In fact, doctors and colleagues and I often discuss this issue. Our feeling is that sometimes it is accurate and sometimes it is not.

Through nearly half a year’s contact, we found that the rapid detection of nucleic acid at home is helpful to analyze the cause of upper respiratory tract infection in the community. In particular, the newly added pertussis test is convenient for early investigation and is really useful.

However, the detection rate of individual pathogens is doubtful, and some testing items seem unnecessary.

Here are two valuable cases. These two children not only did a quick home nucleic acid test, but also measured a very accurate tNGS (targeting high-throughput sequencing), which can be compared and analyzed.

As always, thank parents for their consent before sharing.

01

Case 1

A 7-year-old child saw a doctor at 12 noon on June 21st. The medical history is as follows:

When I saw a doctor, I had been coughing for 5 days. Because his deskmate was recently diagnosed with whooping cough, according to the clinical diagnosis standard B of CDC in the United States, if other diseases are excluded, whooping cough can be clinically diagnosed without laboratory tests.

Considering the 14-day course of antibiotic treatment and whether the family members take post-exposure prevention, after discussion with parents, it was decided that the presence of pertussis should be determined by rapid examination in JD.COM, and the drug-resistant pertussis infection should be evaluated by targeted sequencing. The specific plan is as follows:

At 15: 16 (more than 2 hours after sampling), the quick test results show that:

At noon on June 22nd (the second day after seeing a doctor), targeted sequencing showed that:

Through this case, we can draw the following conclusions:

1. The Bordetella pertussis detected this time is accurate (confirmed by sequencing).

2. The Streptococcus pneumoniae strain detected this time is false positive (negated by sequencing).

Why is there a false positive?

It is speculated that the primer design for rapid detection of Streptococcus pneumoniae in laboratory has defects and insufficient specificity, and Streptococcus angina with similar nucleic acid sequence is mistaken for Streptococcus pneumoniae.

3. The Haemophilus influenzae detected this time is accurate (confirmed by sequencing).

4. Targeted sequencing can identify whether there is drug resistance gene mutation in Bordetella pertussis, which is convenient for drug selection.

Reminder again: We must seize the opportunity to treat pertussis, because at present, drug-resistant pertussis is the main epidemic in China, so compound sulfamethoxazole is recommended as the first choice for empirical treatment.

▲ Guidelines for diagnosis, treatment and prevention of whooping cough in China (2024 edition)

02

Case 2

3 years and 7 months, I saw a doctor on July 13th (Day 2), and my medical history is as follows:

Initial diagnosis of acute laryngitis (mild). Because the symptoms suggest viral infection (especially parainfluenza virus), no pathogenic test was made at the first diagnosis.

The children returned home with high fever that day, and the parents made a quick inspection of the US delegation. The results are as follows:

You see, the US Mission has detected three kinds of "conditional pathogens" quickly, but there is no parainfluenza virus detection project, which makes parents feel strange.

In the next few days, the progress of this child’s illness is worrying.

On the 14th (Day 3), repeated high fever, the highest is 40.1℃.

On the 15th (Day 4), the highest temperature was 40.7℃. I went back to the clinic for targeted sequencing.

On the 16th (Day 5), sequencing showed that:

On the 16th (Day 5), the child developed yellow tears. His body temperature was 39.7℃ during the day and nearly 40.1℃ at 10 pm. My parents contacted me.

Combined with the sequencing results and the change of symptoms, I considered the virus combined with bacterial infection, and started amoxicillin and clavulanate potassium that night.

On the morning of the 17th (Day 6), the body temperature gradually dropped and pus increased. My temperature has been normal since the afternoon of the 17th.

Through this case, we can draw the following conclusions:

1. The Streptococcus pneumoniae strain detected this time is false positive (negated by sequencing).

2. The Pseudomonas aeruginosa detected this time is false positive (negated by sequencing).

3. The Haemophilus influenzae detected this time is accurate (confirmed by sequencing).

4. The parainfluenza virus detected by sequencing is the pathogenic pathogen that causes the initial symptoms of children, but the detection project has been cancelled by Meituan (which has been kept by JD.COM Quick Inspection so far).

5. The sequencing results are helpful for judging the virus combined with bacterial infection, and this result is also the basis for my difficult decision to start antibiotic treatment at 11 o’clock on the 16th.

03

Is home nucleic acid testing accurate or not?

Any new thing can’t be perfect, there will always be some problems that need to be constantly improved and improved.

Since it is an improvement, it should be improved as possible.

For example, it is very good to add pertussis and group A streptococcus detection items to the home quick inspection.

However, the US Mission cancelled the parainfluenza virus detection and increased the detection of Pseudomonas aeruginosa and Klebsiella pneumoniae with low value, which is puzzling.

Pathogen detection is very important for the management of some infectious diseases, so we should have higher requirements, which is not too much.

If the test results are inaccurate, some pathogens will always be false positive, which will not only lead to patients’ (or their families’) worries, but also lead to wrong intervention, increase the doctor’s interpretation cost and waste the doctor’s time.

The two cases I cited earlier are just cases, which are not convincing enough. Whether home nucleic acid is accurate or not depends on a large sample survey.

We can collect enough home nucleic acid and targeted sequencing results, and then analyze the difference of pathogen positive rate; If a patient has done home nucleic acid and targeted sequencing at the same time, the control analysis is more valuable.

Ben WeChat official account plans to write a series of articles to discuss how to manage common upper respiratory tract infectious diseases by home quick check-up.

Here, I especially hope that the testing organization will make this product better. For example, quality control personnel should carefully analyze the test data, find out the reasons for the high detection rate of pathogens such as Streptococcus pneumoniae, resume the detection of parainfluenza virus, and cancel some unnecessary tests.

In order to make a more rigorous evaluation, we collect home nucleic acid test results from readers, and the requirements are as follows:

1. Provide a complete test report screenshot. If there are other pathogen detection reports (such as targeted sequencing or antibody detection results), they can also be provided together. Please cover the patient’s name.

2. Sampling sites (such as throat swab and nasopharyngeal swab) can be provided.

3. Can inform the patient’s age, main symptoms (such as fever, cough, runny nose) and city.

https://www.wenjuan.com/s/uuqEBnn/

Thanks for your support.

　

The pediatrician slides up to see the next one.

Original title: "Quick test of nucleic acid at home, is it accurate or not? 》

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　　The Work Plan for Improving Medical Services in Beijing in 2024 was recently released. In 2024, the city will realize the direct connection between more than 200 second-and third-grade hospitals and the unified platform of the city’s appointment registration. At the same time, tertiary hospitals or core hospitals of medical associations are encouraged to delegate a certain proportion of appointment examination authority to family doctors.

　　Encourage the delegation of appointment examination rights to family doctors.

　　In 2024, non-emergency medical institutions above the second level will implement a comprehensive appointment, and the appointment time will be accurate within 30 minutes; Optimize the unified platform for appointment and registration in the whole city and the appointment and registration service of secondary and tertiary hospitals, and realize the direct connection and information sharing between more than 200 secondary and tertiary hospitals and the platform number sources. Second-and third-tier hospitals should publicize the appointment registration process through multiple channels, display the real-name information and professional expertise of visiting experts, and provide online intelligent or manual consultation services to facilitate patients to accurately select registration departments; Optimize the registration process and simplify the operation links such as binding identity information; In the corresponding treatment unit, do a good job in interpreting the results after the patient’s examination results are returned.

　　Two weeks before the hospital’s regular numbering cycle, 22 municipal hospitals reserved the numbering sources for patients from other places who came to Beijing and made appointments for referral between clinics, and then put all the available outpatient numbering sources into regional medical centers and community health service institutions through the grassroots appointment referral platform, so as to fully guarantee the demand for family doctors to make appointments for referral. This Municipality encourages tertiary hospitals or core hospitals of medical associations to delegate a certain proportion of the authority of appointment examination to family doctors, and give play to the role of family doctors in appointment examination.

　　Promote online inquiry of waiting order.

　　Combined with the characteristics of clinical specialties and patients, second-and third-grade hospitals will carry out fine classification management on patients who see a doctor during normal hours, who are late for the number, and who continue to see a doctor after receiving the test results, and constantly improve the scientific and reasonable waiting and calling rules. In more than 30 hospitals, online query of waiting queue and call order can be realized.

　　Third-level hospitals will enrich the business scope of outpatient "one-stop" service centers, integrate the service functions such as stamp review, consultation and guidance, manual appointment, and convenience equipment rental, and strive to achieve "one cabinet for all"; Strengthen the management system of day surgery, continuously increase the proportion of day surgery to elective surgery, and reduce the burden of hospitalization needs; Continue to open a green channel for daytime surgery for primary medical and health institutions.

　　Medical institutions will pilot the management of "one bed in the whole hospital". The Municipal Health and Wellness Committee encourages qualified hospitals to conduct centralized management and unified deployment of beds in the whole hospital. Second-and third-level hospitals will comprehensively promote the mutual recognition of inspection results and the sharing of electronic medical records. More than 170 second-and third-level hospitals will realize online inquiry of inspection reports and medical images.

　　Update and release the map of rare disease diagnosis and treatment institutions.

　　The city will promote second-and third-grade hospitals to access the city’s Internet hospital service platform, and expand the connotation of Internet diagnosis and treatment services, from traditional diagnosis and treatment services such as online follow-up, appointment registration, prescription, drug distribution, inspection and appointment inquiry, and payment, to full-process services such as health management before diagnosis, health consultation, health assessment, disease screening, patient follow-up after diagnosis, and chronic disease management.

　　The coverage of the use of electronic bills for financial medical charges will be broadened, and the full coverage of the application of electronic bills for financial medical charges issued by patients with special diseases (emergency) and observation in municipal hospitals will be gradually realized; Gradually promote hospitals to provide patients with electronic bill printing services for financial medical charges through self-service equipment, artificial windows and other different ways.

　　In addition, the relevant departments will conduct a survey on the diagnosis and treatment capacity of medical institutions within the jurisdiction of this Municipality according to the second batch of rare diseases catalogue, synthesize the list of the first batch of rare disease diagnosis and treatment institutions and departments, update the list of rare disease diagnosis and treatment institutions and departments in this Municipality, and publish a map.

In the TOPCon battery workshop of Jinneng Technology, the AGV automatic guided vehicle is loading and unloading the battery basket (data picture).

　　The spring breeze is mighty, and everything germinates. In March, the National People’s Congress kicked off.

　　"Promote the construction of a modern industrial system and accelerate the development of new quality productive forces. Promote the optimization and upgrading of the industrial chain supply chain, implement the high-quality development actions of key manufacturing industrial chains, accelerate the development of modern producer services, and promote the specialized and innovative development of small and medium-sized enterprises. Actively cultivate emerging industries and future industries, implement industrial innovation projects, and promote the development of strategic emerging industries integrated clusters. Deepen the innovation and development of the digital economy, actively promote digital industrialization and industrial digitalization, and promote the deep integration of digital technology and the real economy. " The government work report pointed out that in 2024, the development of new quality productive forces will be accelerated, policy continuity will be maintained, and coordination of various policies will be strengthened to form a joint force to promote high-quality development.

　　Seek the layout of the article and open your eyes to the outline. Shanxi, a big energy province, how to be a pioneer, write a new chapter and make more contributions to the overall situation of the country? Faced with the hot word "new quality productivity", our province is taking the lead in solving problems with a sense of urgency and the driving force of hard work.

　　Where to solve the problem?

　　The core element of "innovation" is indispensable.

　　New quality productivity, as the name implies, is the leading role of "innovation", which is free from the traditional economic growth mode and productivity development path. It has the characteristics of high technology, high efficiency and high quality, and is an advanced productivity that conforms to the new development concept.

　　"New-quality productivity is born out of technological revolutionary breakthrough, innovative allocation of production factors, and deep transformation and upgrading of industries. The basic connotation is the leap of laborers, labor materials, labor objects and their optimized combinations, and the core symbol is the substantial improvement of total factor productivity. Its characteristics are innovation, the key is high quality, and the essence is advanced productivity." The relevant person in charge of the Innovation Department of the Provincial Department of Industry and Information Technology introduced.

　　At the beginning of the new year, "new quality productivity" can be described as the key word for deploying economic work from the central government to the local government. At the National People’s Congress and the National People’s Congress, the government work report put "promoting the construction of a modern industrial system", especially accelerating the development of new quality productive forces, at the top of this year’s important tasks.

　　For Shanxi, if high-quality development is a "mountaineering competition", then the new quality productivity is undoubtedly a "commanding height". In the process of climbing towards the "commanding heights", the core element of "innovation" is indispensable.

　　The provincial party committee and government have already made it clear that only by insisting on innovation as the first driving force and fully implementing the innovation-driven development strategy can Shanxi be led to the fast lane of high-quality development. Last year, our province launched policies such as "Action Plan for Supporting Shanxi’s High-quality Development with Science and Technology Innovation Platform" and "Implementation Plan for the Open and Innovative Development of Service Trade in the Province". At the beginning of this year, the "Three-year Action Plan (2024-2026) for the Construction of Innovation Drive Platform in Jinchuanggu" was officially promulgated, and the general office of the provincial government immediately issued five supporting policies, including policies and measures for the establishment of science and technology teams and enterprises in Jinchuanggu Innovation Drive Platform, aiming to focus on key areas and build a number of innovation consortia.

　　It is not difficult to see that today’s Shanxi insists on "topping" innovation and turning it into tangible actions.

　　How to dig?

　　Accelerate the construction of a modern system with distinctive advantages.

　　Industry is the carrier of the development of new productive forces. At the end of October last year, the Provincial Department of Industry and Information Technology and Huawei Technologies Co., Ltd. jointly held the "Entering Huawei" digital industry docking activity in Shanxi Province in Shenzhen and Dongguan, Guangdong Province. The event brought together the relevant heads of digital industry authorities and investment promotion departments in Taiyuan, Datong and Shanxi Comprehensive Reform Demonstration Zone, and came to the coast of the South China Sea from the west foot of Taihang to promote the investment environment and key industry policies, and conducted exchanges and docking, field research and accurate investment promotion around Guangdong’s advantageous industries in the field of science and technology, which fully demonstrated the strength of digital economy development in our province.

　　At the beginning of March, large-scale transport vehicles shuttled in the industrial park of Taizhong Intelligent High-end Hydraulic Excavators located in Xiaohe Emerging Industrial Park, Shanxi Comprehensive Reform Demonstration Zone, and a number of high-end hydraulic excavators newly rolled off the production line were "lined up" waiting to be delivered to Zhejiang, Jiangsu, Sichuan and other provinces as well as overseas markets such as America and Southeast Asia.

　　The new round of scientific and technological revolution and industrial transformation are advancing by leaps and bounds. Intelligent manufacturing is regarded as the main direction of building a strong manufacturing country, and it is also a "strong springboard" for the development of our province. Since last year, our province has implemented a new round of technological transformation of enterprises, and provincial technological transformation funds have supported 28 projects with 590 million yuan.

　　With the continuous deepening of high-end, intelligent and green, the pace of Shanxi’s "new" to "green" is more steady and powerful. Last year, our province vigorously improved the level of technological innovation, newly cultivated 52 provincial-level enterprise technology centers, and 4 enterprises entered the public list of national enterprise technology centers. Accelerate the promotion of 150 key technologies and 130 key projects, and build a total of more than 93,000 5G base stations, and complete the "14 th Five-Year Plan" construction task two years ahead of schedule. The province’s industrial Internet logo analysis secondary node application was approved to reach 16, of which 8 were connected with the national top nodes, and the comprehensive index and scale of computing power ranked seventh in the country.

　　How to exert strength?

　　Deep integration of emerging industries and cutting-edge technologies

　　It is not difficult to find that in recent years, the pursuit of emerging industries and cutting-edge technologies and the deep integration of the two have made Shanxi more confident in solving the problem of new quality productivity and made high-quality development more possible.

　　"Specific to the traditional coal industry, accelerating the development of new quality productivity requires breakthroughs in three aspects, namely, scientific and technological innovation, industrial upgrading, and reform and change." Zhao Jianze, chairman of Shanxi Coking Coal Group, said.

　　In recent years, the group has carried out core technology research in key areas around six research and development directions, such as coal mine intelligence, green and safe production in mines and clean and efficient utilization of coal, and made every effort to seek breakthroughs; Take the lead in undertaking the national key research and development plan "large-scale mine comprehensive tunneling robot" project, carry out the key scientific and technological project of Shanxi Province "Technology and demonstration of high-efficiency water-saving mining of coal resources", and obtain a number of innovative achievements in the core technology field; Through the research and development of integrated technology of "mining, washing, blending, transportation and marketing", we will dig deep into the scarce and high-quality attributes of coking coal resources and take digital coal blending as the starting point to further form new profit growth points.

　　The train runs fast, thanks to the headband. Nowadays, the "heart" of freight train head is hydrogen fuel cell stack, which is also the key device to convert hydrogen energy into electric energy. As the "chain owner" of Shanxi hydrogen energy industry chain, Shanxi Pengfei Group cooperates with Shanghai Hydrogen Morning New Energy Technology Co., Ltd. to improve the conversion rate and service life of hydrogen fuel cell stacks. After the "freshly baked" stack is systematically synthesized, the life of the fuel cell system finally assembled on the hydrogen energy heavy truck of Pengfei Group can exceed 20,000 hours. In eight months, 100 hydrogen energy heavy trucks ran 12 million kilometers, and the admirable productivity became the core competitiveness of Pengfei Group.

　　Build a number of industrial platforms, such as CLP Digital Economy Industrial Park, No.7 Shanxi Zhichuang City, and "Digital Wisdom City" in Yuxian County; Held Yangquan 2023 Digital Wisdom New City Construction Forum and Industrial Development Conference, and signed 21 projects with a total investment of 5.586 billion yuan; The number of registered enterprises in the core industries of digital economy in the city exceeds 3,000 … The digital economy in Yangquan City is rising with the wind, showing a trend of industrial agglomeration.

　　Just at the beginning of the year, the "chain length system" of key industrial chains in our province also set the annual target and task: The "Action Plan of Shanxi Key Industrial Chain" for 2024 "clearly states that we will build and strengthen the chain around key industrial chains, optimize the institutional system, refine the development path, strengthen service support, and strive to break through 700 industrial chain enterprises by the end of 2024, and the overall revenue will exceed 700 billion yuan, maintaining a two-digit level.

　　Cultivating and strengthening new quality productivity is a long-term task and systematic project. Experts said that it is necessary to further deepen the reform in an all-round way and form a new type of production relationship that is compatible with it. Deepen the reform of economic system, science and technology system, make great efforts to break through the blocking points that restrict the development of new quality productive forces, establish a high-standard market system, innovate the allocation mode of production factors, and let all kinds of advanced and high-quality production factors flow smoothly to develop new quality productive forces … In Shanxi, the "road map" described in the government work report is being transformed into vivid "realistic paintings". (Wang Longfei Wang Lei)

　　When infected with COVID-19, we should pay attention to light diet and avoid eating properly, especially the following three kinds of food. When infected with COVID-19, it is best to eat less or not.

　　1. High-salt food

　　High concentration of salt can inhibit the activity of respiratory cells, inhibit their disease resistance, at the same time, it can also reduce saliva, reduce lysozyme in the mouth, and increase the chance of virus and bacteria infection in the upper respiratory tract.

　　When infected with COVID-19, you should eat less salt, and the average adult without diarrhea or profuse sweating should be controlled within 5g every day, which will help to increase the content of lysozyme in saliva and help the body to secrete more immunoglobulin A and interferon to deal with Covid-19.

　　2. Spicy food

　　During illness, many people’s digestive function will weaken. At this time, too spicy and irritating food will make the already messy gastrointestinal function more disordered, and even cause the risk of nausea and vomiting.

　　In addition, COVID-19 is often accompanied by sore throat. For people who are intolerant of spicy food, spicy food will also stimulate the pharynx and aggravate the discomfort of the pharynx.

　　3. indigestible food

　　After being infected with COVID-19, many people have weak gastric motility. Eating too much food with high dietary fiber content will increase the burden on the stomach and even cause vomiting. At this time, you should eat less foods such as konjac, celery, leek, chrysanthemum, sweet potato, etc. In addition, you should eat as little or not as much as possible, such as uncooked miscellaneous beans and chewy beef and mutton pieces.

　　So, during the period of COVID-19 infection, which diets are helpful to relieve the illness?

　　1. 2000 ml of water every day

　　The World Health Organization suggested that COVID-19 should be replenished with enough water during the positive period, and a small amount of water should be injected several times throughout the day.

　　Usually, the average adult can drink 1500-1700 ml of water every day. If there are no special drinking taboos (such as heart and kidney problems), for the average adult, when infected with COVID-19, the amount of water should be more than usual, reaching 2000 ml per day. Ordinary-sized disposable paper cups contain about 200 ml of water.

　　Drink more water and urinate more, so that the waste produced by metabolism in the body can be excreted in time, which also helps to dissipate heat. Be careful to drink warm water, not too cold water.

　　2. Light soup and porridge

　　When sick, people’s gastrointestinal function deteriorates, and light soup and porridge are relatively easy to digest. At the same time, hot soup and porridge can play the role of sweating and accelerate the process of "self-healing". After sweating, we should pay more attention to the supplement of water.

　　3. Steamed chicken and fish

　　The World Health Organization suggests choosing foods rich in protein, such as beans, fish, eggs and lean meat. When the human body is relatively weak in COVID-19, properly supplementing high-quality protein will help the body recover.

　　Chicken and fish contain many kinds of amino acids necessary for human body, and its protein is easy to digest and absorb. Steaming is light and not so greasy, so it is suitable for eating in COVID-19. Be careful not to swallow the fishbone when eating fish.

　　4. honey

　　Half an hour before going to bed, eat a small spoonful of honey (about 10 grams) in moderation, which will help relieve cough discomfort at night. Pay attention to the fact that babies under one year old can’t eat honey.

　　Text/Yu Kang

　　(Professor, Department of Clinical Nutrition, Peking Union Medical College Hospital)

In recent years, reports about "superbug" are common. It is no longer just the concern of medical workers, but has become a global problem.

"Superbacteria" actually does not refer to a specific bacteria, but generally refers to those bacteria that show resistance to at least three kinds of commonly used antibacterial drugs in clinic. Its academic name is "multi-drug-resistant bacteria".

In the face of "superbugs", only by understanding their characteristics and transmission mechanism can we better slow down their production and curb their spread.

"past lives" of Multi-drug Resistant Bacteria

Penicillin was discovered by alexander fleming in 1928. This powerful "sharp weapon" for treating bacterial infections saved countless lives in World War II. However, with the widespread use of penicillin and other antibacterial drugs, the first superbug in history-methicillin-resistant Staphylococcus aureus appeared, and then more and more superbugs appeared.

According to the report of China Bacterial Resistance Monitoring Network, the main clinical problem in China is Gram-negative bacilli which are resistant to carbapenems. The data in the first half of 2023 showed that the resistance rate of Acinetobacter baumannii to carbapenems was as high as 79.5%. These shocking data highlighted the seriousness of bacterial resistance in China.

In 2022, the authoritative medical magazine The Lancet published a survey of 204 countries and regions around the world in 2019. The study showed that antimicrobial resistance directly led to more than 1 million deaths, which even exceeded the number of people killed by malaria or HIV infection; The number of indirect deaths is even more alarming: nearly 5 million people. In 2016, the global research report on drug-resistant bacteria infection commissioned by the British government showed that by 2050, nearly 10 million people will lose their lives every year due to antimicrobial resistance.

Dr Margaret Chan, former Director-General of the World Health Organization, once pointed out that with the increasing and spreading of multidrug-resistant bacteria, common infection may once again become a fatal threat. This is not an alarmist. When human beings encounter the dilemma of no medicine available, even trivial wounds or respiratory infections may easily take their lives, and human beings will undoubtedly return to the dark period before the discovery of penicillin.

Why do drugs "fail" to bacteria?

Drug resistance of bacteria refers to the tolerance of bacteria to antibacterial drugs, which can be divided into congenital drug resistance and acquired drug resistance. Congenital drug resistance refers to the innate tolerance of bacteria to certain antibacterial drugs, which can be passed down from generation to generation; Acquired drug resistance means that bacteria "acquire" drug resistance genes due to spontaneous gene mutation or from other drug-resistant bacteria. Drug-resistant bacteria usually refer to acquired drug-resistant bacteria.

Drug resistance of bacteria is actually the result of natural selection in the process of evolution. In the process of its growth and reproduction, the reasons for promoting drug resistance involve many aspects, such as gene mutation or variation of bacteria, improper use of drugs and decreased immunity of the body, which may be the potential reasons for drug resistance.

The abuse of antibacterial drugs is an important factor leading to bacterial drug resistance. "Abuse" is mainly manifested in two aspects: unreasonable use in the treatment of human diseases and excessive and improper use in animal husbandry. Due to the selection pressure of antimicrobial agents, those bacteria with drug resistance will be naturally selected and multiply, thus accelerating the reproduction and spread of drug-resistant bacteria.

Multi-drug-resistant bacteria are mainly transmitted through contact, such as blood, sputum, urine or secretions of patients carrying multi-drug-resistant bacteria; Or contact with equipment, fabrics and pools contaminated by multi-drug resistant bacteria; For respiratory tract infection or colonization of multidrug-resistant bacteria can also be spread through droplets.

Antibacterials that have been "misunderstood"

The public’s understanding of antibacterial drugs is relatively limited, which leads to drug abuse becoming a common problem. There are 10 common misunderstandings in the use of antibacterial drugs, which need to be corrected as soon as possible:

1. Antibacterials are omnipotent anti-inflammatory drugs;

2. Do not distinguish the causes of colds, and use antibacterial drugs;

3. Antibacterials are the first choice for fever;

4. Diarrhea is inflammation, and it is best to use antibacterial drugs;

5. Broad-spectrum antibacterial drugs have stronger antibacterial ability, and the therapeutic effect is often better than narrow-spectrum antibacterial drugs for specific pathogens;

6. Newly listed and expensive antibacterial drugs are preferred;

7. The combination of multiple antimicrobial agents can effectively control infection;

8. It doesn’t matter if antibacterial drugs are frequently replaced;

9. Self-preventive use of antibacterial drugs during the high incidence of respiratory diseases in winter and spring.

10. The medication is not standardized, not enough, and the medication will be stopped if the symptoms improve slightly.

Abuse of antibacterial drugs will not only lead to bacterial resistance, but also lead to a series of serious adverse reactions, among which allergic reactions are particularly common, such as itchy skin, rash and other symptoms, and even life-threatening conditions such as anaphylactic shock may occur in severe cases; Some drugs may also cause nervous system symptoms, such as headache and dizziness. Some antibacterial drugs can also have toxic effects on hearing and kidneys; Abuse of antibacterial drugs will destroy the balance of flora in the body, which will cause a large number of inhibited bacteria to multiply and cause double infection.

Standardize drug use and prevent drug resistance

Remember 7 points.

1. Don’t buy drugs at will: Most antibacterial drugs belong to the category of prescription drugs. You must issue a doctor’s prescription when buying them, and you can’t buy them online or in a physical pharmacy at will.

2. Don’t choose your own medicine: When choosing which kind of antibacterial drugs to use, it should be judged by professional doctors according to the condition and clinical test results, not just by advertising or personal experience.

3. Do not use drugs at will: When using antibacterial drugs, we should follow the doctor’s advice to ensure that they are taken after professional diagnosis in the hospital, and do not blindly abuse drugs, especially for some daily ailments (such as colds), it is not appropriate to use antibacterial drugs easily.

4. Do not stop taking drugs without authorization: Once you use antibacterial drugs, you must follow the doctor’s instructions and take the drugs on time, according to the dosage and according to the course of treatment.

5. Pay attention to personal hygiene: frequent hand washing, more ventilation and avoiding close contact with patients are helpful to prevent infection.

6. Strengthen exercise: enhance physical fitness and immunity, and reduce the use of antibacterial drugs from the source.

7. Don’t throw drugs at will: expired drugs belong to harmful waste, so they should be thrown into the hazardous trash can to prevent criminals from recycling them. Garbage sorting, protect yourself and others.

The doctor concluded:

The increasingly serious problem of drug-resistant bacteria has become a major challenge in the field of global public health, which is attracting widespread attention from the medical community, government and society. In daily life, we should pay attention to developing healthy living habits, ensuring clean diet, actively exercising to enhance our immunity, and at the same time, we should follow scientific principles and standardize the use of antibacterial drugs. The whole society needs Qi Xin to work together to slow down the emergence of drug-resistant bacteria and curb its spread.

Text | Shen Chunmei

Deputy Chief Technician, Department of Hospital Sense, Fifth People’s Hospital Affiliated to Fudan University

Editor | Wang Jingming

Audit | Ye Haixia

Producer | Li Wenjing

Medical Support | Shanghai Medical Association Science Popularization Branch

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Hainan province novel coronavirus epidemic prevention and control work headquarters
Notice on the continuous implementation of prevention and control measures for normalized epidemic situation

Joan pneumonia refers to [2021] No.35.

The epidemic prevention and control headquarters of cities, counties, autonomous counties and Yangpu Economic Development Zone, and the member units of the provincial epidemic prevention and control headquarters:

From 10: 00 on August 19, 2021, Yunlong Industrial Park in Haikou High-tech Zone of Haikou City was adjusted from a medium-risk area to a low-risk area. So far, our province is all low-risk areas. In order to implement the prevention and control strategy of "external defense input and internal defense rebound" and make overall plans for the prevention and control of normalized epidemic situation and economic and social development, in view of the grim situation of overseas epidemic situation, there are still a number of medium and high-risk areas in China, and the risk of importing epidemic situation into our province still exists. The relevant matters concerning the continuous implementation of normalized epidemic prevention and control measures in our province are hereby notified as follows:

First, continue to prevent the risk of epidemic input.Immigration personnel strictly implement the "14+7" control measures, that is, after the expiration of 14 days of centralized isolation, they will be subjected to medical observation at home for 7 days. Those who have lived in high-risk areas within 14 days will be kept in isolation for medical observation for 14 days after entering Qiong, and their nucleic acids will be tested as required. If there is a history of sojourning in an epidemic area within 14 days (prefecture-level cities and districts with medium and high risks in China, the same below), they shall pass with a negative certificate of nucleic acid detection twice within 48 hours (24 hours apart). Those who do not hold the nucleic acid test certificate will be tested at the port after arriving in Qiong. Each port can take centralized or home waiting for the results according to the specific situation, and individuals should do a good job in health monitoring. All cities and counties should pay close attention to the epidemic situation in all parts of the country, keep abreast of the situation in medium-and high-risk areas in China in a timely manner, carry out the investigation of people coming (returning) from medium-and high-risk areas in China, people with red and yellow codes, and people entering ports in other provinces in accordance with laws and regulations, accurately and scientifically implement health management service measures such as health monitoring, nucleic acid testing, and isolated observation, and resolutely implement "all the discharge should be done, all the inspection should be done, and all the management should be taken care of".

Second, continue to implement the prevention and control measures for the normalization of the epidemic.Compacting the "four-party responsibility", overcoming paralysis, war-weariness, luck and relaxation, and doing a good job in epidemic prevention and control with caution. Airports, docks, railway stations, bus stations and other key traffic places, shopping malls, supermarkets, farmers’ markets, wholesale markets and other crowded places should strictly implement normalization prevention and control measures such as wearing masks, temperature detection, checking health codes, "one-meter line", disinfection of public areas, and reducing waiting time; Internet cafes, bars, theaters, chess rooms, restaurants, libraries, museums and other closed public places, to control the flow of visitors, the implementation of wearing masks, temperature testing, regular ventilation and strict disinfection measures; Hotels should conscientiously implement real-name registration, wearing masks, temperature detection, checking health codes, regular disinfection and strict tableware disinfection, advocate non-contact ordering and checkout, recommend using public chopsticks and spoons, and remind diners to keep their distance.

Third, continue to implement prevention and control measures for gathering activities.According to the principle of "who holds it, who is responsible", we will formulate epidemic prevention and control plans and emergency response plans, and implement prevention and control measures such as wearing masks, temperature testing and checking health codes. Conference and exhibition organizers should control the density of participants and the scale of the conference; The establishment of personnel information database, in principle, within 14 days, there are high-risk areas and epidemic areas living history personnel do not attend the meeting; Do a good job in the temperature detection and investigation of admission personnel. Admission personnel must wear masks in a standardized manner throughout the whole process, and timely isolate and investigate those who have symptoms such as fever, fatigue and dry cough. Advocate "red things" and "white things" to keep everything simple and control the number of participants.

Fourth, strengthen the prevention and control of epidemic situation in key industries.Strengthen the responsibility of industry departments and strictly implement the epidemic prevention and control measures in various industries. Especially tourism, catering, fishery, cold chain transportation and other industries with strong mobility, miscellaneous contacts and high risk of infection, it is necessary to organize various forms of COVID-19 prevention and control knowledge training and publicity and education, so as to improve employees’ awareness and ability of self-protection. It is necessary to strengthen the health monitoring of temporary workers and take the initiative to ask about their living history. All kinds of schools at all levels should prepare for the start of school. Those who fail to meet the requirements of epidemic prevention and control, fail to implement prevention and control measures, and fail to implement effective emergency plans and drills can’t return to school. Strictly implement the self-health monitoring of teachers and students 14 days before the start of school, and complete nucleic acid detection and isolation measures for teachers and students with medium and high risks as required before returning to school, so as to prevent them from returning to school with diseases and risks.

Fifth, strengthen the management of high-risk groups.Twelve types of key industries, such as railways, highways, waterways, civil aviation, ports, medical and health care, and imported cold chains, should find out the personnel base, register and register them, and achieve "due inspection and complete inspection" in time according to the requirements of the Notice on Adjusting the Requirements of Covid-19 Nucleic Acid Detection for the Key Population "Should Check and Complete Inspection" and the Notice on Doing a Good Job in File Management of Key Posts by the COVID-19 Epidemic Prevention and Control Headquarters.

Six, strengthen the management of key places.Airports, ports and other places where inbound personnel (excluding those from Macao), inbound cold chains and other goods and the environment are in direct contact with handling, cleaning, quarantine, border inspection, flow inquiry, sampling, transshipment and boarding operations are subject to closed-loop or closed management. The personnel shall adopt a shift system with a certain working period, with centralized accommodation and closed management during the working period, and point-to-point transshipment between the workplace and the place of residence to avoid contact with family members and ordinary people in the community. International and domestic flight workplace staff should be fixed posts, and cross operations are prohibited.

Seven, strengthen the management of key institutions.All kinds of medical institutions, especially grass-roots clinics, strictly implement the responsibility system of first consultation, standardize the pre-inspection and triage of infectious diseases, strengthen the information reporting and closed-loop management of fever patients, and ensure that all fever patients are treated in fever clinics (consultation rooms). All kinds of medical institutions at all levels that have not set up fever clinics should refer patients with related symptoms in COVID-19 in strict accordance with the regulations. Drug administration and other departments should strengthen the monitoring of the sales of antipyretics in retail pharmacies. Medical care, pension and other key places should strictly implement measures such as wearing masks, temperature testing and checking health codes.

Eight, strengthen the prevention and control capacity building.Accelerate the construction of multi-point trigger early warning system, enhance the sensitivity of epidemic monitoring system, resolutely implement the "four early" measures, and strictly prevent late reporting, omission and concealment of epidemic situation. Improve all kinds of prevention and control plans, plans and work guidelines at all levels, effectively strengthen the training and drills of all kinds of prevention and control personnel on prevention and control knowledge, ensure that emergency response can be quickly launched in the event of sudden epidemic, and scientifically standardize the organization and implementation of emergency investigation and disposal. Strengthen the capacity building of fever clinic, full-time nucleic acid detection, rapid and accurate flow tracing, and standard setting of isolation points to fill the shortcomings.

Nine, steadily promote vaccination.Steadily promote the second vaccination work for young people aged 12-17. Increase the intensity of the second dose vaccination for people aged 18 and above, especially for those who have not been vaccinated with the second dose for more than 21 days, to ensure that people of the appropriate age who have no contraindications should "take everything" and those in key industries should "take everything".

Ten, strengthen the public awareness of prevention and control.Make full use of radio, television, WeChat WeChat official account and other publicity platforms, strengthen epidemic prevention and control policies and personal protection knowledge publicity, and strive to enhance people’s awareness of prevention and control, health literacy and vaccination. Guide the masses to actively participate in epidemic prevention and control, consciously abide by various measures, adhere to scientific wearing masks, keep social distance and pay attention to personal hygiene, and gather less and flow less. It is advocated that those who do not go to overseas, domestic high-risk areas and epidemic-related areas unless necessary should go to Beijing, go through the boarding formalities with the negative certificate of 48-hour nucleic acid test, report to the local community (village) and work unit in time after returning to Qiong, and consciously accept health management services.

Novel coronavirus epidemic situation in Hainan province.

Prevention and control work headquarters

August 19, 2021

(This piece is made public voluntarily)

1905 movie network news On August 18th, Xie Yuan, a former teacher of Beijing Film Academy, died at the age of 61 because of a sudden heart attack. Mr. Xie Yuan has been teaching in Nortel for more than 20 years, and has taught many excellent actors. Huang Lei and Sun Li were his students.

Huang Lei sent a message in Weibo to pay tribute to Mr. Xie Yuan, saying: "I was shocked to hear that Teacher Xie Yuan suddenly left, and my heart was extremely heavy and sad. Teacher Xie was my teacher and my old colleague. We also worked together in two plays, Snowstorm Night Return and I Love My Boyfriend. In the play, we were also teachers and friends. In addition to filming, we were friends with wine and chess. He was also a mentor of Sun Li University for four years. Teacher Xie is enthusiastic and active, has a wide range of interests, is optimistic by nature, and is kind to others. On weekdays, he is a warm man among friends and is happy. Thank you for going all the way. May you be safe in heaven. "

Sun Li also sent a message through Weibo to remember her teacher: "Thank you, my mind is full of your vivid appearance, I don’t want to believe it, thank you for your teaching, and go all the way!"

Recently, actor Bao Beier exposed himself as the "king of bad movies" in a public interview, which quickly triggered a heated discussion among netizens. # Bao Beier # Entertainment # Gossip # Star # Hotspot

Bao Beier, an actor who once became famous for his comic role, has frequently appeared in some films with poor reputation in recent years, which makes many fans feel confused and disappointed. Is his self-disclosure a helpless move or a form of compromise? This issue is not only related to Bao Beier’s personal career choice, but also reflects the various difficulties of the current film and television industry.

Phenomenon review

Bao Beier’s self-exposure as the "king of bad movies" is undoubtedly a frank reflection on his career. In the interview, he said that although he has been trying to choose a good script, the final works are not always as expected. This phenomenon is not an isolated case. Many actors will face similar choice problems after becoming famous. On the one hand, they hope to take high-quality works and improve their artistic level; On the other hand, market demand, investor pressure and personal livelihood considerations often force them to make a trade-off between quality and quantity.

The collision of views of public opinion

For Bao Beier’s self-exposure, public opinion presents two completely different voices. Some people think that as a public figure, Bao Beier should be responsible for his own works, and should not sacrifice his artistic pursuit for short-term benefits. They believe that actors should have higher professional ethics and choose works that can convey positive energy and have artistic value. Others hold a more tolerant attitude, thinking that in the current highly competitive entertainment industry, actors are under great pressure to survive and sometimes have to make compromises. After all, not every project can guarantee success, and not every attempt can be recognized by the audience.

Deep-seated cause analysis

Bao Beier’s self-exposure actually reveals a common problem in the film and television industry: the contradiction between commercialization and artistry. With the influx of capital, many film productions pay more and more attention to the box office revenue, while ignoring the artistic and cultural connotation of the works. This has led to the proliferation of some shoddy films in the market and even affected the healthy development of the whole industry. In addition, the rise of the network platform also makes the content production more diversified, but it also brings the problem of uneven quality.

Educational significance and values

From Bao Beier’s self-exposure, we can see an important educational significance: as a creator, we must stick to our original intention and constantly improve our professional quality. At the same time, the audience should also treat each work rationally and give more understanding and tolerance. After all, every film is the result of the joint efforts of the team, which contains the sweat and hard work of many people. We can’t totally deny an actor’s efforts just because one or two works are not satisfactory.

Positive effects and potential risks

Bao Beier’s frank attitude won the understanding and support of some audiences, which also won some positive comments for him. However, such self-exposure may also bring negative effects, such as damaging personal image and even affecting future job opportunities. Therefore, how to find a balance between keeping the truth and protecting their own interests is a problem worthy of consideration by all artists.

Summary and appeal

In a word, Bao Beier’s exposure of "the king of bad movies" is not only his personal reflection, but also a warning to the present situation of the whole film and television industry. In this challenging era, we need more excellent works to enrich people’s spiritual life, and we also need a more rational audience to support those who really work hard. Let’s look forward to a healthier and more prosperous film and television environment!

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The Toyota Asian Dragon leads the way in mid-size sedans with its unique design style. The front face features bold lines and streamlined design, and the air intake grille is decorated with large areas of chrome to create a strong visual impact. The overall body lines are smooth, showing a steady and dynamic appearance, showing the style of a high-end business car.

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